What do you want to say to midwives?

[Whistleforit]

Have been asked to speak to a conference of them about What Matters to Women from patient perspective. Come on, what you got for me? :)

I was very lucky to have a fantastic community midwife for my pre-natal care and excellent midwives during my very difficult delivery.
As I live on the border of 2 boroughs I had community midwives from a completely different area for my post-natal care whom I'd never net before despite ring them in advance to see if I could meet them and they were quite probably the most unfriendly, dismissive and rude women I've ever met.

Don't ask me at 3days post delivery if I didn't notice DS was a bit yellow, I've never had one of these before and your colleague yesterday told me there was nothing to worry about.

Don't presume you will just examine my stitches on my SOFA with no gloves on.

Do not tell me when I'm 10 days post delivery and on the brink of being sectioned due to PTSD from my awful delivery, that my GP is being ridiculous to give me ADs and that I've just got a bit of the baby blues.

You are in my home and should be respectful of that.

It took 2.5 years and 3 different ADs and hours of CBT for me to feel better and I still feel cheated of those first few months of DSs life and one of the things that is most vivid in my memory is how useless, patronised and degraded I felt by those women.

DS will be 5 soon and DH and I are hoping to start trying for number 2 in the new year, we have already had discussions with GP about how my pregnancy/delivery might be managed in the hope I'm not stuck with PND again and I hope that MW who care for me will ALL be lovely this time

Sorry EPIC post!

RedToothBrush. I know. There's also the fact that in obstetrics the really big payouts are for babies who have been brain damaged. They're normally not settled for quite a few years, often over ten as both sides need to see how severely the child is affected to determine damages.

So for instance this year a hospital could pay £12million for a case dating from 15 years ago. Then next year their premiums will go up even though current care, training and guidelines will be very different from 15 years ago.

Well done for putting mothers' views across, Whistle! Sounds like a very important and interesting talk.

I am a community midwife and have been qualified since 2002.

Every single day I try to do the very, very best for the women in my care. I genuinely care and worry about my patients. I sincerely hope that I have never been rude or dismissive to any woman or partner. My care is "woman centred", I believe that consent, gentleness, professionalism and choice are at the core of my role.

I am currently looking after women with their 3rd pregnancies with me as their midwife, which I find lovely (and hope that they do too). I spend a long time getting to know the women and building a trusting relationship (I hope). I would never, ever perform any examination or procedure without clear consent. For example, if a woman comes to my clinic for a sweep, I will ask her if she wants one, explain the procedure and before I touch her I ask "may I examine you now? You say when you are ready for me to go ahead". I also tell them that if they want me to stop the examination to either say stop or raise their hand and I promise that I will stop.

This thread makes very sad reading at all the horrible experiences that many women have had. It has been a real eye opener to have read all of your experiences and I have taken all of the comments on board regarding poor care.

One other thing that I do that patients may not be aware of is, if I have had to admit someone to hospital (eg for raised BP) I always phone in to the ward to find out how my patient is. I don't think this is ever communicated to the patient.

I would just like to say that, if any of you have ever been a patient of mine, it is very likely that I have laid in bed worrying/thinking about you.

I was just remembering yesterday how when I had just had a c section, the midwife manhandled the babe and my nipple to make the two connect presumably so she could tick a box to say the child had been put to the beast straightaway. It felt totally unnatural and ridiculous as I was laid flat and she was manhandling my nipple into position. I breast fed the previous 2 and this one for 15 months each and so was not going to not breastfeed. It felt like a very mild form of abuse as I did not plan for this nor want it, and wasnot invited to join in this process. I can't remember at what stage of the process htias was but I seem to remember it being pretty soon after giving birth as I was still laid out flat and in some transition location, not back on the ward.

This was 8 years ago so maybe it has changed now. Was it about ticking boxes, do you think?

shaky you sound lovely, the mw I saw at antenatal clinic was a lot like you but she was the only one out of many who genuinely seemed to care.

FTR, that sounds horrendous. Have you thought of a doula? It might be worth the extra money if you can afford it? Just having them there, with all their experience and knowing they are in your corner no matter what, just like your dh, might really help you.

whistleforit I think your speech sounds great.

shaky the model of care you have described as your practice is the sort of care I desperately wanted. Please please keep up the good work.

Tell them women need just as much reassurance and TLC in the first 24 hours after birth, as they do in labour. It is not good enough to assume they are coping OK. Even confident seeming women can feel very fragile with a first baby - they need time, and reassurance, just as much.
Seeing staff constantly supporting a girl obviously classed as 'in need', while you are left alone to handle a baby who won't feed, is vomiting, and covered in meconium while you can barely stand up to try and change the nappy ...... well, it just makes a new mum feel totally alone.
Of course the girl in need was entitled to all the help, but everyone should get that backup. Ward management practices need to come back up to levels which support all new mums properly.

When I posted my birth story on here after ds was born, a poster berated me for my description of my treatment, saying I was needy and pathetic, and Mw were there to make sure the baby was ok. The poster said I needed to get a life and not have expected to be " Molly coddled"

Lots of ladies shouted the poster down and were horrified at her vitriol, one saying she was a Mw and I had been treated appallingly, and Mw have a duty of care.

I have long nc, but I haven't forgotten someone thinking it is ok to treat a woman who has just given birth so badly. The pre natal ward was awful too. The labour room Mw were amazing, which was lucky, seeing as I was sobbing in the belief that I would be giving birth with these bullies present, and was begging dh to take me away from there - anywhere- another hospital, just drive. " crying again dear? Don't worry so much, lots of ladies have to be cut, you won't be the only one. Dont worry, ill decide on the day! All this fuss! "

shaky, exactly as hazchem says, all the stories on here make me think care like yours is a treasure that every expectant mum should have access too. Pls don't shake, be proud and out there changing the world one baby at a time :)

I really appreciate your post shaky. One thing that I'd like to ask you though is that whilst I appreciate midwives have to ask whether the present baby has the same father as the last are you aware that there are polite and impolite ways of asking. I shall never forget the midwife who came to my home, drank my tea, didn't really seem to be listening and then came out with "has It got the same father as your first child".

She was in my home, a guest. She was in a room with my starting to date wedding photos, my name for the first pg was the same as it was on that day. She called my baby "It". She could have said "I know this is a difficult question but we have to ask because the risks of pre-eclampsia I hope you don't mind." I was very nearly illegitimate and have borne the shame of that my whole life - the night before my wedding the old family GP when I went for an emergency pill prescription because I had forgotten to pack them said "oh, you're a bit more careful than your mother then".

"It" was born at 27 weeks - He, Alexander, died a few hours later. I have never forgiven her for minimising his worth to me when he was twelve weeks formed. Not least because she did it in my drawing room as my guest and I was a married woman bearing a very planned baby.

My midwife told me not to shout at her. I was hysterical with pain, back to back labour, induced and on drip, epidural stopped working. I was in agony and literally just wanted to die.

She told me off for crying, I sobbed that I couldn't help the way I was. She told me not to shout at her and called me a drama queen.

She was also abrupt to me the following night when on the ward and I was struggling with bf. I was too afraid to ask for help after that and just lay there crying until a lovely midwife came along to see what was wrong.

So from that perspective I would say that midwives need to remember that for a lot of first time mums it is scary, terrifying, painful, and many other things.

A bit of empathy would go a long wAy and that woman should not have been allowed to make me feel like that. :(

I want to say 'Thank you' to all the brave and hardworking midwives out there who save the lives of mothers and babies every day in the UK.

Thank you in particular to my IM who saw me through two challenging labours (and also did me a BOGOF for the second!).

I want to say to some midwives: I know you are tired and under pressure, but if you regularly find you are unable to emotionally engage with women in labour in a sincere way, then you should take some time out, go part-time, or reassess whether you have the stamina to continue working in the NHS.

They should have a nursing degree for a start and specialise into midwifery. Poor skill standards are the core issue.

Not the case AT ALL. Nursing is completely different to midwifery, the two shouldn't even be compared - most nurses and midwives agree which is why there's quite a bit of animosity between the two.Nursing is predominantly helping people who have had to have medical intervention, midwifery is about guiding a woman who is going through something natural and giving support. It's a completely different sort of learning. Both courses are massively in depth and Midwifes - especially modern ones- are taught above and beyond what they need to know.

^As a midwife you are running from one room to the next praying that you manage to be in the right place at the right time when something goes wrong (when, not if!).

So what is happening is things are going wrong and everyone knows about it and tolerating it.

This is called negligence and if it is happening, then why isn't the whistle being blown by those in the profession? ^

They do. It's been brought up time and time again. There's been petitions, letters to PM's, complaints to those higher up the food chain - nothing is done. We need a minimum of 5000 more midwives to be able to give people the care they deserve. But the government refused the proposal.

There are the good and there are the bad.

DD1: Induction, left completely alone at 19 throughout the whole process bar from pessary and actually pushing stage. Was made to believe my contractions in those hours alone were constepation and given senokot. Was all alone in pain and they left me on a ward alone, boyfriend wasn't allowed with me as according to them i wasn't in labour. That's until they caught me screaming in the toilet pushing!!
BELIEVE me when I say i'm in labour regardless of what your bloody machine says. It's my body, i know!

DD2: Induction again but very pleasant, sent there early morning. Assigned a male midwife, he was superb, believed me not the machine and was with me through transition & pushing and gave me pain relief as soon as i asked for it.
Thankyou for taking your time to take care of me and give me a good experience, even had a radio put on for me

DD3: Dear midwife, i didn't want a student present but felt made to agree- read my notes!!
When meconium is in my waters, do not lie about my child being fine in there!!! I can see the heart monitor dipping tremendously.
I asked for a c-section as my baby was in distress, but you left it too late and my legs were forced into stirrups whilst you used the ventouse which my partner had to agree to. If you had of listened my child i believe would not have speech delay and autism. The lack of oxygen i believe affected her, i asked for a csection 3 timed but no you didn't listen to ME.
I kicked the doctor in the head because i told you NO to a ventouse!!

DD4: oh where to start , went in as my waters broke and you made me sit on a monitor for 3 hours then told me not to come back unless in labour. Came back in strong labour but again machine says NO so i'm disbelieved until some bitch examined me and then realises that yes i'm bloody 7cms. Again i should know, it's MY body.
30 mins later i start pushing, told im not ready and nearly gave birth with my knickers on!!!

Don't disbelieve a mother in the throws of labour, with no5 due early january i suspect the machine won't show my contractions and depending on the mw be disbelieved again. This time i will make you believe me!

Shaky - You sound lovely and I really hope, based on my booking appointment, that I might have a midwife like you for my current pregnancy. She seems lovely and I'm looking forward to her being my midwife.

I suppose the only thing to say is that, for many women, they may have had a damaging experience before they see you. I've been thinking, and of the many, many midwives I saw across two pregnancies (don't think I saw the same one twice in any ante or post natal, so despite being straightforward I saw many) only one was poor. Sadly that one poor midwife did masses of damage to my perception of midwives and my trust. You only give birth I guess 1-3 times for most women. It makes sense to be massively cautious about who you trust after a bad experience. You don't have the benefit of the odds to keep saying if it was a one-off. You sound very lucky that you get the chance to build trust with your mothers. I am not sure how midwives in hospital are best advised to work through that.

Married - I am so sorry to hear about Alexander.

Read the patient's notes. Midwives tried to discharge me after 6 hours despite consultant writing I had to stay for 72 for observation for my pre-existing medical condition.
Then - treat your patients with respect please, even if they don't look like they're dying because of a birth related injury. I was treated like cr*p for the first 24 hours because "there was nothing wrong with me", until my condition flared (which was expected by the consultant). Then they panicked and treated me like a human being! (And ran round like headless chickens, because they had no idea what to do - I refer you to point 1)

Pumpkin, I had similar with DS1, kept being told I wasn't in labour despite it being blatantly obvious to anyone with eyes that I was, because the fucking machine said I wasn't! I've never heard of anyone else whose contractions weren't picked up, I'm sorry you went through it but I'm pleased to hear it's not just me! I'm pregnant with DS2 now and will be having a section.

Thank you, sincerely!

Most of you are diligent, caring and skilled. To one of you I am forever indebted for her phenomenal 1:1 support of me during dc2's birth. I will never forget her or the experience which was life-affirming in every sense.

I cannot begin to tell you how low this thread has made me feel.

I became a midwife after having a bad experience with my 3rd child. I was desperate to make a difference and help women achieve the birth experience they want. I believe I am a good midwife (but don't all of us?). As has been previously stated, I introduce myself, ask before touching, inform what I'm doing & why, ask open questions, involve partners etc. I am well aware I do this on a daily basis, but for the woman it is not a common occurance for a stranger to "stick their hand up her fanjo".

I have seen bad practice and reported it, but nothing like some of the experiences discussed here. As in any profession, there are good and bad but I honestly believe the majority are good.

Do women truly think we, as midwives, sit idly by and never voice our concerns regarding staffing, workload, management etc? NOBODY is listening to us. This isn't just us moaning. All this directly impacts on the care we provide and I for one, regularly go home feeling I've done a mediocre job. Our role is slowly expanding and we are being asked to perform tasks which doctors have spent years training to do.

Please do not think we are happy with our lot. The majority of us are fighting our corner so we can provide better care.

lost This thread asked for us to to say what we want to say to midwives. Lots of it is negative, some of it has been positive. I wrote about the negative things that need to get said because I said the the positive to the midwives that respected me, listened to me and cared about me.

I find your comment about women thinking midwives are sitting idly a bit disingenuous. Should women not comment about the problems they have had? Or things they would like to be better? Isn't that also assisting the improvement of midwifery services and provision?

I'll say what I said earlier women and midwives are on the same side.

Hazchem Yes on same side when it goes well. I think the way the system is organised in a lot of places - where women are processed through each phase without any relationships with/as individuals - does seem to break that down. And a lot of posts on here reflect that which I, like lost, find profoundly depressing.

My take is that the system is not working well for either side and needs fundamentally changing. Ideally by someone who has had a baby: I.e. not some bloke/politico who is never on the sharp end and therefore sees it as a depersonalised cost-cutting endeavour.

Re: sharp end, ideally someone who had had a baby and delivered loads of em so actually knows loads about it.